AHCA/NCAL Population Health Summit Targets Providers

11/7/2019

Patrick Connole

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​Long
term and post-acute care (LT/PAC) providers seeking information and the
strategic know-how to launch specialized Medicare
Advantage (MA)
plans, or Special Needs Plans (SNPs), for their long-stay residents have an
opportunity to do so at a December conference organized by the American Health
Care Association/National Center for Assisted Living (AHCA/NCAL) with its Population
Health Management Summit for Long Term and Post-Acute Care Leaders.

AHCA/NCAL
sources tell Provider that as
interest continues to grow among LT/PAC providers in the Institutional-SNP, or
I-SNP sector, so does the need for information geared specifically to skilled
nursing and assisted living owners and operators.

“Every population
health management conference that comes up seems to focus on how hospitals,
health systems, or physicians can manage the post-acute care stay,” says Jill
Sumner, vice president, population health management, AHCA. “These conferences
are never about the PAC provider taking the lead.”

Thus, in
consultation with Mark Parkinson, president and chief executive officer of AHCA/NCAL,
and other association leadership, the idea was born to bring LT/PAC into its
rightful place in the discussion through a summit on the world of population
health management in general and SNPs in particular, Sumner says.

Since she
arrived at AHCA in October of 2018, the association has worked to develop the
resources and capacity to aid LT/PAC providers in pursuing population health
management opportunities, which also made the summit a natural extension of
this effort.

“There is
a strong interest and thirst for knowledge in this area,” Sumner says.

AHCA/NCAL
staked out new ground when it formed the Population Health Management Council earlier
this year as it became clear that there are real opportunities for LT/PAC
providers to gain a level of control over their residents’ care than was
previously possible, she says.

The
goal of the council’s work is to enhance the quality of care and quality of
life for Medicare beneficiaries in senior living settings by ensuring the
sustainability of long term care provider-owned population health models
through advocacy, education, and quality improvement data.

With MA or
other emerging population health management models, providers can flex those
regulations and waive the three-day stay and use financing to hire and train
advanced clinical staff. “It is about keeping people as healthy as possible and
providing them with benefits that do that and trying to avoid as much of the preventable
emergency care as possible,” Sumner says.

For the providers, legal experts,
academics, and others coming to the AHCA/NCAL summit, the agenda items include
an opening keynote: Thriving in a World That Doesn’t Exist by health care
thought leader Dan Mendelson, founder of Avalere Health.

A sampling of the sessions over the
two-day conference cover the expanding role of providers in population health
management, building MA plan and network relationships, overviews from
officials representing the Centers for Medicare & Medicaid Services, and the
nuts and bolts of SNP development.

Council
partners AllyAlign Health, American Health Partners, and Provider Partners
Health Plan will also play a featured role at the summit, Sumner says. She stresses
that providers and other stakeholders who are just thinking about getting
involved in the world of SNPs will find what they need at the summit, as well
as those entities already deeply along the way in managing their own MA plan.

“We do
have something for both ends of the spectrum,” Sumner says. For example, actuaries
from Milliman will review how the MA plan bid process works, which is something
every plan sponsor must manage on a yearly basis, not just for the first time
out.

“That is a
fundamental technical session that would appeal to folks just getting in and
those already into it. The bid process is very involved and takes hearing a
number of times to understand completely,” she says.

In the
end, the summit is about how LT/PAC providers can best engage with their
business partners and take a leadership role, be it by working with payers or through
integrated health networks or entering into value-based contracts. “We are
trying to set the overall tone as providers taking a leading role on working
within the system and not trying to push against it,” Sumner says.